Used for centuries to heal wounds and cuts, St. John’s wort is much better known today as an herbal antidepressant, especially after research comparing it to known antidepressants such as Prozac (Fluoxetine).

St. John’s wort (Hypericum perforatum L. Clusiaceae: Guttiferae)

German name: Johanniskraut, Common names: grass for the wounds

It is a perennial plant with yellow flowers and characteristically dotted leaves that resemble perforations, from which the Latin name (perforatum) originates. It grows on abandoned meadows of hilly and middle mountain belts, and blooms from May to September.

Traditional use

Used for centuries externally to treat cuts, burns, hemorrhoids, for wound healing and as an antiseptic, and internally against stomach ulcers, gastritis, liver and intestinal diseases.

The ancient Greek herbalists Hippocrates, Dioscorides and Galen, used it as a diuretic, to treat wounds as well as neuralgic conditions. The Swiss doctor Paracelsus used St. John’s wort to treat psychiatric disorders. Traditional European medicine has for centuries recorded the use of the tops of St. John’s wort in bloom, to treat neuralgia, anxiety, neurosis and depression. In the 19th and 20th centuries, American eclectic doctors prescribed this herb to treat hysteria, nervous attacks, and depression, and externally to treat wounds.

What does St. John’s wort contain and how does it work?

This plant contains: Catechin tannins, flavonoids hyperoside, quercetin and rutin, phloroglucinol hyperforin, naphthodiantrone hypericin and pseudohypericin.

What part of the plant is applied?

The apical parts of the plant in bloom, which contain the most medically active ingredients.

What do modern scientific research say about the effectiveness?

• A study comparing the conventional antidepressant fluoxetine (Prozac) and St. John’s wort in the treatment of mild to moderate depression showed that plant was just as effective but had fewer side effects than this conventional drug.
• Recent research into the treatment of unipolar major depression has shown that preparations are just as effective as standard antidepressants in treating this disease, and that they have fewer side effects than these conventional drugs.
• In the treatment of moderate to severe depression, extract has been shown to be as effective as paroxetine (Seroxat), but extract is better tolerated.
• St. John’s wort extract has been shown to be as effective as sertraline (Zoloft) in treating moderate depression. Extract is also well tolerated.
• Extract relieves PMS symptoms as well as menopausal symptoms.
• Cream with extract has been shown to be effective in treating mild to moderate atopic dermatitis.
• A recent clinical study showed a potential therapeutic effect of St. John’s wort in smoking cessation.
• Recent research has shown the potential use of extract to relieve alcohol withdrawal symptoms.
• In the last ten years, the so-called “Photodynamic therapy”, a method of treating various skin cancers using photosensitizers, ie substances that intensely attract light after being applied to the skin, which leads to the destruction of skin cells, especially cancer cells. St. John’s wort hypericin belongs to the group of photosensitizers that have perspectives in the future development of this type of skin cancer therapy.

What is the medical use?

This plant can be successfully used to treat mild to moderate depression, obsessive-compulsive disorder, premenstrual syndrome, dyspepsia, menopausal disorders, nocturnal enuresis in children, alcohol withdrawal, as well as cigarette addiction. Externally, St. John’s wort in the form of oils and ointments is used to treat wounds, first-degree burns, atopic dermatitis, and to relieve myalgia (muscle pain). In the form of suppositories for the treatment of hemorrhoids, and in the form of vagitories for the treatment of various vaginal inflammations, vaginal herpes, as well as cervical dysplasia.

In what dosage forms is it used?

It is applied in the form of capsules, tablets, tea or tincture for internal use. Extract in the form of ointments, oils, creams, gels, vagitoria and suppositories are used for external use.

How is it dosed?

•  In the form of tea is taken 2-4 grams per day, dried and ground tops of St. John’s wort in bloom.
• Capsules containing 300 mg of extract are dosed 3 times a day.
• Tincture containing 50% of extract is dosed 2 times a day for 2 ml.
• For external use, oil, ointment or cream is applied 3-4 times a day to the affected area.
• Suppositories and vagitories are used once a day or as directed by a doctor.

Is St. John’s wort harmful?

At normal dosage preparations  are not harmful.

If the skin is smeared with St. John’s wort oil and exposed to the sun, burns can occur (phototoxic effect). Therefore, it is not recommended to expose parts of the body smeared to the sun for at least three hours after application.

Are there any interactions with any medications?

Plant may reduce the effective concentration of some drugs such as contraceptives, theophylline, cyclosporine, digoxin, so the concomitant use plant with these drugs should be avoided.

Can preparations be used by pregnant and breastfeeding women?

There are no restrictions on the use of St. John’s wort during pregnancy and lactation.

Image by Radfotosonn, Erika Varga, WikimediaImages from Pixabay